Health policy experts expect a rush to buy coverage as the open enrollment deadline nears, much as there was a surge at the end of December to buy coverage to begin Jan. 1."As there is tremendous media attention on that date, we'll see a similar phenomenon in March," says Sara Collins, vice president for health care coverage and access at the Commonwealth Fund, a foundation that supports an improved health care system.
What's the deal with open enrollment?It's no coincidence that an open enrollment period was introduced as part of the Affordable Care Act. Starting this year, individual health plans must cover a set of standard benefits, and insurers cannot deny coverage or charge higher premiums for people with health conditions. The Affordable Care Act also requires almost everyone to have insurance this year. A time period for enrollment was set to prevent people from waiting until they got sick to buy coverage, Collins says. Health insurers need a large pool of people -- not just those with illnesses - to buy coverage in order to spread risk and keep premiums low. If you miss the March 31 deadline to purchase coverage for 2014, you could get another chance to enroll if you have a special circumstance, known as a "qualifying life event." In most cases you have 60 days after the event to enroll. Those events include:
- Getting married
- Having or adopting a child
- Permanently moving to a new area that offers different health plans
- Losing other health coverage because of job loss, divorce, loss of eligibility for Medicaid or the Children's Health Insurance Program, expiration of COBRA coverage or decertification of a health plan. (A plan is decertified if it no longer meets federal and state standards for health plans.) Losing coverage because you didn't pay the premiums does not qualify you for special enrollment.
- A change in your household that affects eligibility for tax credits or cost-sharing subsidies, if you're already enrolled in a marketplace plan.